<form class="box">

    <div class="field">
        <label class="label" data-localize="username">Username</label>
        <div class="control has-icons-left ">
            <input class="input is-small" type="text" name="username" required>
            <span class="icon is-small is-left">
                <i class="fa fa-user"></i>
            </span>
        </div>
    </div>

    <div class="field">
        <label class="label" data-localize="password">Password</label>
        <div class="control has-icons-left ">
            <input class="input is-small" name="password" type="password">
            <span class="icon is-small is-left">
                <i class="fa fa-key"></i>
            </span>
        </div>
    </div>

    <div class="field">
        <label class="label" data-localize="domain">Domain</label>
        <div class="control">
            <input class="input is-small" type="text" name="domain" placeholder="" required>
        </div>
    </div>

    <div class="field">
        <label class="label" data-localize="proxy">SIP Proxy</label>
        <div class="control">
            <input class="input is-small" type="text" name="proxy" placeholder="" required>
        </div>
    </div>

    <div class="field is-grouped">
        <div class="control">
            <button type="submit" class="button is-link" data-localize="save">Save</button>
        </div>
        <div class="control">
                <button type="button" class="button is-danger btnCancel" data-localize="clean">Clean</button>
            </div>
        <div class="control">
            <div class="file">
                <label class="file-label">
                  <input class="file-input" type="file" name="resume">
                  <span class="file-cta">
                    <span class="file-icon">
                      <i class="fa fa-upload"></i>
                    </span>
                    <span class="file-label"  data-localize="load_from_file">
                      Choose a file…
                    </span>
                  </span>
                </label>
              </div>
        </div>
    </div>

</form>